HomeMy WebLinkAboutPermit Electrical 1992-7-29
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225 FIFTH STREET ' ~ rnddoe'not:'~bmlttedhllS~Lf,CTRlCAL PERMIT APPUCATION
SPRINGFIELD, OREGON 97477 a, , qUlre.peCIf/C/an':u~~oWingn(\\7\l}rt
INSPECTION REQUEST: 726-3769 10nin9_ LfjeJ Ci ty Job Number ~\r1, u:)'-'\
OFFICE: 726-3759 1:)010_ 'l.2.Crczl" _
\ - 3 . COMPLETE FEE SCHEDULE BELOII
1. LOCATION OF INSTALLATIO~horfzed Signature i{
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JOB DESCRIPTION
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Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
IBO days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor ....1::>1
Address I S-o I ?~,- \
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City EVj~-<<- Phone >'-/2 -lsl3
Supervisor License Number <Z;;S-Z --:5 LL-=-
Expiration Date
/(:) - 1- C, <.
Constr Contr. Number 5"'T'7"1r.{
Expiration Date
r~iC?-"i>
Signature of Supervising Electrician
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Ovners Nanie '7Z 1/0)_7>,1. 7J t?/,. N c: T-r
Address(Ol?-/) A\O,DoF)
City ~f6l, Phone 72-6-'673(
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OIlNER INSTALLATION
The installation is being made on
property I own vhich is not intended
for sale, lease or rent.
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Ovners Signature:
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RECEI PT D: .--r-J}, ___ S-=--[!JA
RECEIVED n~ U J
esidential-Single or
Multi-Faml per dwelling
Service Included:
Items
1000 sq.ft. or less'
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
unit.
Cost
Sum
$ B5.00
$ 15.00
$ 40.00
B. Services or Feeders
Installation, Alterations or '
Relocation:
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
$.50.00
$ 60.00
$100.00
$130.00
$300.00
S 40.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
D.
Branch Circuits
$ 40.00
$ 55.00
$ BO.OO
volts see "n" above
Nev. Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 35.00
$ 2.00
not included)
$ 40.00
$ 40.00
'X' $ 20.00
$ 36.00
/JT). CQ
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